Health Partnership - The Michigan WISEWOMAN Lifestyle Intervention
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Implementation

NOTE: This section of the template provides a succinct outline of the basic steps to implement the intervention. For many interventions, a more detailed implementation protocol is also available, and provides a more thorough description of the implementation process. This section also may describe the methods of delivery and the dose and intensity that have been found to be effective in prior tests of the intervention. This does not rule out the possibility that other methods, doses, and intensity may be effective.

How It Works

The basic steps to implement Health Partnership Intervention at the state level include:

  • Contract with the local health department. Make sure they understand everything that will be involved with implementation.
  • Ensure proper staff placement. This includes oversight at the state level as well as staff at the local health department level. (See Staff section under Resources Required.)
  • Conduct on-site training of local health department staff by state staff providing Program Overview and Lifestyle Counseling components (e.g. Stages of Change, educational materials for clients, etc.)
  • Phone calls and site visits to local health departments by state health department staff are conducted to maintain a continuous feedback loop.

Health Partnership Intervention Flow:

  • The client completes a Health History Form and Healthy Lifestyle Assessment at her initial WISEWOMAN session;
  • Lifestyle Counselor shares results pamphlet with client that includes results from the Health History Form and Healthy Lifestyle Assessment, along with screening results (e.g. BP, total cholesterol, BMI);
  • Lifestyle Counselor discusses risk factors in the results pamphlet and guides client through client-driven goal setting process;
  • Client and counselor establish goals in one or two of the lifestyle behavior areas (nutrition, physical activity, and smoking cessation);
  • Lifestyle Counselor encourages client to take small, achievable steps toward goals and the counselor may provide educational materials and/or referrals to free or low cost community resources that will support client in accomplishing goals; and
  • Regular follow-up by the Lifestyle Counselor includes two to five additional contacts with the client, over the course of a year, either in face-to-face (individual or group) meetings or via the telephone to discuss progress toward goals and barriers to achieving success.
  • Client is encouraged to attend annual re-screening appointment.

Dose/Delivery

The contact minutes with the clients for Health Partnership range from 15 minutes to one hour per contact and can take place face-to-face or by telephone. Factors that influence the method of delivery include the availability and preference of the counselor, the availability and preference of the client, travel distance for client, as well as other life issues that may arise (see Barriers to Implementation below). All clients receive 2-5 sessions; the number of sessions is determined by the motivation of the client.

Keys to Success

The Michigan WISEWOMAN Program staff identified the following keys to success re: implementation of Health Partnership Intervention.

  • Relationships – There must be a relationship between the client and the counselor in order for the client to be comfortable. There should also be a relationship between the counselors and the intervention specialist at the state.
  • Regular Contact – This helps keep the client motivated and on track, and it also helps build the relationship.
  • Quality Improvement – We use the data collected on client contacts to provide feedback to the lifestyle counselors in order to ensure the clients receive their sessions.
  • Counselor motivation and time – It is important to have counselors who care about the clients and want to see them succeed. It is also important for the counselor to have the time to make the contacts and to spend time with the clients. If either is lacking, the program will suffer.

Barriers to Implementation

The Michigan WISEWOMAN Program Staff identified the following potential barriers to implementations:

  • Retention – Behavior change is hard, so it is sometimes difficult to get clients to stay motivated and stay with the program.
  • Time spent trying to make contacts – Our counselors ask the clients the best time to call, but the counselors still find themselves making several phone calls before they find a client who will answer the phone.
  • Life – As we often say, “life happens.” Our clients often face difficult circumstances such as domestic violence, economic hardships, and transportation issues. In some cases, the last thing on their mind is eating more fruits and vegetables. So, our lifestyle counselors wind up acting as social workers or therapists just to get the client to the point where she is able to think about her health. Program barriers are so wrapped up with client barriers, that it is difficult to separate them.